DSM-5 and ICD-10

So, you may have come across references to either the DSM-5 (or the DSM-IV) or the ICD-10. These would most likely come up in conversations or articles relating to diagnosis or criteria for mental illnesses.

I thought it would be useful to break down what these actually are, what the listed eating disorders diagnoses are, and how they are different.



DSM

DSM stands for Diagnostic and Statistical Manual of Mental Disorders. It is produced by the American Psychiatric Association and is currently on it's fifth edition (hence DSM-5). The fourth edition (confusingly called the DSM-IV-TR, or just DSM-IV) is very similar to the fifth with regards to feeding and eating disorders. I'll cover both here, because if your eating disorder service is using the DSM to diagnose, they may use either version four or version five.

DSM-5
Lists the following eating disorders:

• Pica
• Rumination Disorder
• Avoidant/Restrictive Food Intake Disorder (ARFID)
• Other Specified Feeding or Eating Disorder (OSFED)
• Unspecified Feeding or Eating Disorder
• Anorexia Nervosa
• Bulimia Nervosa
• Binge Eating Disorder

The diagnostic criteria for each of these can be found on the Eating Disorders Victoria website.

DSM-IV-TR
Lists the following eating disorders:

• Anorexia Nervosa
• Bulimia Nervosa
• Eating Disorder Not Otherwise Specified (EDNOS)

The diagnostic criteria for each of these can be found on the McCallum Place website.
Body Matters has a great article on the differences between the two editions of the DSM. You will notice that there are more specific disorders listed in the DSM-5, including the addition of Binge Eating Disorder. This is to provide more detailed, accurate information to each disorder, rather than using the catch-all term EDNOS. The DSM-5 has also removed the requirement of amenorrhea (absence of periods) from the Anorexia Nervosa diagnosis.

ICD-10

ICD-10 stands for The International Statistical Classification of Diseases and Related Health Problems, tenth revision. It is produced by the World Health Organisation, and covers health as a whole, as opposed to the DSM, which covers mental disorders only.

The following eating disorders are recognised in the ICD-10:

• Anorexia Nervosa
• Bulimia Nervosa
• Overeating Associated with Other Psychological Disturbances
• Vomiting Associated with Other Psychological Disturbances
• Other Eating Disorders.
• Atypical Anorexia Nervosa
• Atypical Bulimia Nervosa

Full diagnostic criteria for each of these can be found on the Eating Disorders Victoria website.

Compared to the DSM, the ICD-10 lists a specific BMI range as a criteria for the diagnosis of Anorexia Nervosa (17.5 or less.) For those under 18, the criteria is that weight is at 15% below the expected body weight. The weight-for-height chart may be used as a reference for the expected body weight.

The ICD-10 does not include specific entries for other disorders such as BED or pica, which are included under the umbrella of Other Eating Disorders. A new edition of the ICD-10 is scheduled for publication in 2018.